Famously, Mumbai-based Cipla forced down the prices of Aids drugs some years ago with the launch of a twice a day pill, which then became the staple treatment in many sub-Saharan countries.

But Medecins sans Frontieres, also known as Doctors without Borders, which played a role in that epic turnaround, is now warning that a Free Trade Agreement between the EU and India could ensure that sort of Robin Hood episode never happens again. Yesterday, its supporters demonstrated in New Delhi. They fear the EU, negotiating behind closed doors, will push or cajole India into recognising tough new intellectual property rights. The winners, it fears, will be Big Pharma, while the losers will be the impoverished sick.

This was Loon Gangte, president of the Delhi Network of Positive People (DNP+):

We are marching to call on the Indian government not to trade away our lives. Lifelong treatment for people living with HIV depends on continued access to newer AIDS medicines. Because of international trade rules that India has already signed in the past, some of our newer AIDS medicines are already patented and completely unaffordable. We are protesting against India’s accepting terms that would further compromise access to life-saving medicine.

This is a complicated issue, which is why it gets little attention in the mainstream press. Trade rules and agreements are tough going for any but the dedicated and the nerdy. But essentially, for some years now Big Pharma has been trying to use its influence over politicians in the US and in Europe (who don’t want to lose the investment, jobs and taxes that drug companies bring at home) to demand tighter rules on the Indian copycats. Patents normally last for 20 years, so drug companies can recoup the millions they spend on R&D. They want India to observe their patents, just as Europe and the US do.

India gets cheaper drugs if the generic whizzkids can knock off copycat versions of the blockbusters. While India is middle-income and getting richer, unfortunately a tough trade agreement with the EU would probably penalise the Indian poor. But it also threatens the poorest of the poor, in Africa and other parts of Asia. Look in an African health centre and all the drugs are Indian-made. With a growing need for new and better HIV drugs in sub-Saharan countries, it may be no time to curb the Indian generic manufacturers.

Meanwhile the lobbying for more money for HIV/Aids moved seamlessly this week from London to Washington, where Dr Peter Mugyenyi, director and founder of Uganda’s Joint Clinical Research Center, gave evidence on the Hill. The Center is the biggest implementer of Pepfar (the president’s emergency plan for Aids relief) funds in East Africa and Mugyenyi was one of a handful of people in the room when Pepfar was conceived in 2003. He says that cuts in US funds for Aids are already beginning to bite. This is what he told me:

I’m panicking about it. That’s how bad it is because I’m foreseeing the return of the catastrophic times of the 90s, when everything in Africa came to a standstill and the hospitals couldn’t function and the staff fled the health service – and many of them died. They couldn’t get access to treatment and had nothing to offer their patients. The patients were abandoning the health facilities and flocking to witch doctors and traditional healers who were clearly helpless.

Could we go back there? Mugyenyi says he is already seeing people with newly-diagnosed HIV turned away from clinics as the orders are given only to carry on treating those already on the drugs. The money has been frozen, he says. And yet only 4 million are on treatment and 10 million need to be – and the WHO’s new guidelines say people with HIV should be treated earlier, which would perhaps double the numbers who should be getting drugs.

Read also Chris Collins of the Foundation for Aids Research in the Huffington Post on the hearings in the House and Senate over the Aids budget.

But good news from the Commission on Narcotic Drugs meeting in Vienna this week. After years of blocking resolutions to encourage access to clean needles to protect drug users from HIV, the Obama administration made a break with the past. This was the verdict of Professor Gerry Stimson, Executive Director of the International Harm Reduction Association:

Real progress was made here this week in Vienna – some countries that in the past tried to obstruct resolutions dealing with harm reduction and human rights have backed off. The big – and welcome – development is the US position. The fresh approach of the Obama administration to the UN and to international drug and HIV/AIDS policy is making itself felt. US officials here for the first time were able to voice their support for HIV-related risk prevention measures, and for HIV prevention firmly based in human rights. Let’s hope this continues to play through in the years ahead – if so we are going in the direction of a more rational global response to drug-related harm.

So all eyes are now on Russia, where 65% of HIV infections comefrom injecting drug users, and which turns a blind eye.